When we see someone with a psychosis, we often think of the strange behaviour that they might be exhibiting as the problem, the thing that needs curing. I remember seeing a man on the tube with a large length of thick, bright green rope wrapped around his head and upper body.
Why might this man have tied himself up in this manner? Perhaps, a little like the woman in Darian Leader’s vignette below, he feared that his body would fall apart if it wasn’t held together.
In which case, the fear of falling apart would be the real psychotic delusion (the primary phenomenon); the wrapping himself in rope would be a perfectly, logical attempt at a cure (the secondary phenomenon).
The point of Leader’s lecture, is that the psychotic subject has probably tried, with varying degrees of success, to give his or her life some meaning, some bearing, some bearability. Freud, at the end of the Schreber paper, writes:
“The paranoiac builds [the world] up once more [...] in such a way that he can live in it again. He builds it up through the work of his delusion. What we take to be the production of the illness, the formation of the delusion, is in reality the attempt at a cure, the reconstruction. [...] the individual has regained a relationship to the people and things of the world, often a very intensive one, even if what was once a relationship of expectant tenderness may now be one of hostility.”
It might be highly destructive - for the rope man, entirely shattering - for the therapist or doctor to go against this work that the psychotic has been doing.
I’ll put a question out there, and then come back to it: does fantasy work in the same way? Is fantasy the neurotic’s attempt to cure himself? Here’s one we can use as an example: a man whose wife is often away on business fears that she might leave him, and he pictures her having sex with other men while she is away. The primary phenomenon here might be a fear of rejection, which stems from his childhood and is somewhat hardwired. So how might the jealous fantasy act as a way of rebuilding his world?
Leader suggests that the delusion contains three types of curative work for the psychotic:
a) it appeals to, or tries to pin down, a meaning of some sort. I feel like this means something, I can’t work out what it means, but I feel like this meaning concerns me.
b) it attempts to calm excess bodily excitement. There is a “too much” that I feel in my body, and I will go running or go to the gym or try to harm myself in order to still that “too much”.
c) it tries to install a bearable distance. Leader makes the excellent point that every day we need something to mediate our relationships with others - we never say, “let’s meet up”; we say, “let’s meet up for a coffee”.
(How) does our neurotic’s jealous fantasy try these three types of cure? It certainly fixes meaning: now his yawning, objectless fear of rejection has a specific scene (his wife fucking a man other than him) to worry about. And this particular one - the commonest of all? - contains some enjoyment, even if it’s a pretty sickly form of enjoyment. There is a charged eroticism to this scene, and it wouldn’t surprise us if the man got off on it, masturbated to it perhaps ... which takes us to Leader’s second area of cure. The man’s body may be stilled by his ejaculation. And, classically, the scene includes a third person, the “other man” who mediates the relationship between his and his wife. I’m not quite suggesting we all say, “darling, shall we meet up for a threesome,” but I do think that’s why we’re all so fascinated by threesomes: the installation of a bearable distance.
I’d be interested to hear a distinction between delusion and fantasy - there certainly is a distinction, though I’m not sure whether it is qualitative or quantitative. But I do think the psychotic’s delusion and the neurotic’s fantasy have the same purpose: to build the world up in such a way that it is liveable.
